Nurse-Physician Communication Around Identifying Palliative Care Needs in Nursing Home Residents

Steen, Jenny T. van der; Jongen, Esmée A.; Dekker, Natashe Lemos; Bagchus, Lotje; Pasman, H. Roeline W.; Onwuteaka‐Philipsen, Bregje D.; Achterberg, Wilco P.

doi:10.1016/j.jamda.2021.09.034

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…This is supported by Kastbom et al (2019), a study that underlined integrating diverse views in order to receive input and support from each other 73 . Furthermore, as confirmed by van der Steen et al (2021) 74 , our study showed that physicians wish nurses to have a proactive attitude, be competent and report objectively. Most studies about IPC targeted nurse-physician collaborations 75-77 .…”

Section: Discussionsupporting

confidence: 84%

The development of a guidance document for interprofessional collaborative advance care planning in dementia care

Khemai

Janssen

Dongen

et al. 2023

Preprint

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Advance care planning (ACP) is an essential part of palliative dementia care and should embrace a collaborative approach involving persons with dementia, family members and various healthcare professionals (HCPs). This study aimed to develop a guidance document for IPC in ACP in dementia care for HCPs from nursing homes, using a mixed-method design and taking an appreciative inquiry approach comprising semi-structured focus groups and interviews with HCPs. The study participants (N=18) included certified nurses, registered nurses, a quality nurse, nurse specialists, team leaders, physicians specialized in old age medicine, psychologists, and a teacher/researcher (mean age 43.8 years; 79% female). The data analysis indicated six elements to include in the guidance document. The first three elements concerned common awareness of collaborative ACP in dementia care, role clarification for various professions, and actively working towards shared goals in collaborative ACP in dementia care. The last three themes focused on the dynamic processes in collaborative ACP in dementia care: interprofessional communication, coordination, monitoring and evaluation. This study provides a guidance document that HCPs could use in practice to identify the elements they can address to improve collaborative ACP in dementia care.

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Section: Discussionsupporting

confidence: 84%

The development of a guidance document for interprofessional collaborative advance care planning in dementia care

Khemai

Janssen

Dongen

et al. 2023

Preprint

View full text Add to dashboard Cite

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Challenges in recognizing and discussing changes in a resident’s condition in the palliative phase: focus group discussions with nursing staff working in nursing homes about their experiences

Bagchus,

Zee,

van der Steen

et al. 2024

BMC Palliat Care

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Background Most nursing home residents have complex care needs, require palliative care and eventually die in these facilities. Timely recognition of changes in a resident’s condition is crucial for providing appropriate care. Observations by nursing staff play a significant role in identifying and interpreting these changes. Methods Focus group discussions were conducted with nursing staff from ten nursing homes in the Netherlands to explore their experiences and challenges in recognizing and discussing changes in a resident’s condition. These discussions were analysed following the principles of thematic analysis. Results The analysis of the challenges nursing staff face in identifying and interpreting changes in a resident’s condition, resulted in three themes. First, that recognizing changes is considered complex, because it requires specialized knowledge and skills that is generally not part of their education and must partly be learned in practice. This also depends on how familiar the nursing staff is with the resident. Furthermore, different people observe residents through different lenses, depending on their relation and experiences with residents. This could lead to disagreements about the resident’s condition. Lastly, organizational structures such as the resources available to document and discuss a resident’s condition and the hierarchy between nursing home professionals often hindered discussions and sharing observations. Conclusion Nursing staff’s experiences highlight the complexity of recognizing and discussing changes in nursing home residents’ conditions. While supporting the observational skills of nursing staff is important, it is not enough to improve the quality of care for nursing home residents with palliative care needs. As nursing staff experiences challenges at different, interrelated levels, improving the process of recognizing and discussing changes in nursing home residents requires an integrated approach in which the organization strengthens the position of nursing staff. It is important that their observations become a valued and integrated and part of nursing home care.

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Nurse-Physician Communication Around Identifying Palliative Care Needs in Nursing Home Residents

Cited by 2 publications

References 10 publications

The development of a guidance document for interprofessional collaborative advance care planning in dementia care

The development of a guidance document for interprofessional collaborative advance care planning in dementia care

Challenges in recognizing and discussing changes in a resident’s condition in the palliative phase: focus group discussions with nursing staff working in nursing homes about their experiences

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